"Anatomical" versus "territorial" belonging of the middle hepatic vein: virtual imaging and clinical repercussions

The Journal of Surgical Research
Arnold RadtkeM Malagó

Abstract

Venous drainage patterns are of vital importance in live donor liver transplantation. The purpose of this study was to delineate "anatomical-topographical" and "territorial-physiologic" patterns of the middle hepatic vein (MHV) in a 3-D liver model as determined by the Pringle line and its drainage volume of the right and left hemilivers. One hundred thirty-seven consecutive live donor candidates were evaluated by 3-D CT reconstructions and virtual hepatectomies. Based on right (R) and left (L), anatomical (A) and territorial (T) belonging patterns of the MHV, each individual was assigned to one of four possible types: type I:A(R)-T(R); type II:A(L)-T(L); type III:A(R)-T(L); type IV:A(L)-T(R). Couinaud's anatomical MHV variants A-C were subsequently included in our combined anatomical/territorial MHV belonging classification. The MHV showed a significant predominance of right "anatomical" (59.1%) and left "territorial" belonging patterns (65.7%). The paradoxical combinations A(R)-T(L) (type III) and A(L)-T(R) (type IV) were encountered in 36.5% and 11.7% of cases, respectively. The constellations Couinaud's A-belonging type IV and Couinaud's C-belonging type IV were predictive of right hemiliver venous congestion. (1) Almost ha...Continue Reading

References

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Citations

May 12, 2012·Abdominal Imaging·Brunella BarbaroLorenzo Bonomo
Dec 20, 2015·Current Problems in Surgery·Dan E AzaguryBrendan C Visser
Jul 19, 2012·Transplant International : Official Journal of the European Society for Organ Transplantation·Bong-Wan KimKwangil Lee
Apr 27, 2018·Abdominal Radiology·Rishi Philip Mathew, Sudhakar Kundapur Venkatesh
Jul 3, 2018·Korean Journal of Radiology : Official Journal of the Korean Radiological Society·Xiao-Ping YinYong-Xia Zhao
May 12, 2017·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Jianfei ZhangHongjin Sui
Jan 24, 2021·Journal of Hepato-biliary-pancreatic Sciences·Taiga WakabayashiUNKNOWN Study Group of Precision Anatomy for Minimally Invasive Hepato-Biliary-Pancreatic surgery (PAM-HBP surgery)

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